Donation form

Feel free to print out the form below it that is helpful:

SEND THIS SIDE IN WITH DONATION!

Donated to Make-A-Wish Foundation of Nebraska by:

NAME ______________________________________
ADDRESS____________________________________
CITY _____________________ ST _____ ZIP _______

Enclosed is my gift of $ ______________.

_____ Check or Cash Enclosed.  (make checks out to “Make-A-Wish Foundation of Nebraska”) OR

_____ Please charge my credit card for the amount listed above

                 ___ Visa ___ Mastercard
Card # ____________________________________
Expiration Date _____________________________
Signature __________________________________


mail to:
Make-A-Wish Foundation of Nebraska, Inc. 11926 Arbor Street, #102
Omaha, NE 68144

 
              Please apply to Mike’s Make-A-Wish bike ride!

           -------------------------------------------------------------------------

You are invited!

This is your invitation to help me make a dream wish come true for at least 14 Nebraska children with life threatening medical conditions!

Mike’s Ride for Make-A-Wish                       

June 1-30, 2011                           
30 days and 
3,000 miles on a bike!
The goal is $100,000+ for
Make-A-Wish Foundation of Nebraska

A pledge of 1 cent/mile = $30
A pledge of 2 cents/mile = $60
A nickel/mile =          $150

ANY amount is appreciated!!      THANK YOU!!!!
                                                            Mike Reiners
                                                            Grand Island, NE 

For more details, google        
    mikes-make-a-wish-ride.blogspot.com